Background: Riedel thyroiditis (RT) is a rare form of thyroiditis; thus, data about the disease course and treatment options are limited. Therefore, we aimed to assess the clinical, serological, radiological, and histopathological features, as well as short- and long-term follow-up of RT patients under glucocorticoid (GC) and tamoxifen citrate (TMX). Parameters related to IgG4-related diseases (IgG4-RD) were also investigated. Methods: Eight patients with RT diagnosed between 2000 and 2019 were enrolled. Data were collected in a retrospective and prospective manner. The diagnosis was confirmed with histopathological features in all patients. Results of the treatment with GCs on short- to mid-term, followed by TMX in the long term, were evaluated. Results: The mean age at diagnosis was 40.5 ± 6.8 years; female predominance was observed (F/M:7/1). Parameters related to IgG4-RD, like increase in IgG4 serum levels, total plasmablast counts, and IgG4+ plasmablasts, were negative in most of our patients in both active and inactive states of the disease. Likewise, an increased ratio of IgG4/IgG-positive plasma cells #x3e;40% could only be observed in 2 cases. GCs followed by TMX were given to the patients with an over-all median follow-up time of 67 (8–216) months. All the patients considerably improved clinically and had a reduction in the size of the mass lesion on GCs, followed by TMX therapy. None of the patients had a recurrence under TMX therapy for a median period of 18.5 (7–96) months. Conclusion: Even though RT is suggested to be a member of IgG4-RD, serologic or histological evidence of IgG4 elevation or positivity is only useful for diagnosis and follow-up of RT. The diagnosis should be based on clinical and radiological evidence and confirmed by histopathology. GCs are effective for initial treatment, and TMX is a successful and safe therapeutic option for long-term maintenance therapy.
Eur Thyroid J

中文翻译：

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他莫昔芬柠檬酸盐治疗的长期结果以及 Riedel 甲状腺炎的组织和免疫病理学特性

背景： Riedel 甲状腺炎 (RT) 是一种罕见的甲状腺炎。因此，关于病程和治疗方案的数据是有限的。因此，我们旨在评估糖皮质激素 (GC) 和他莫昔芬 (TMX) 下放疗患者的临床、血清学、放射学和组织病理学特征，以及短期和长期随访。还研究了与 IgG4 相关疾病 (IgG4-RD) 相关的参数。方法：招募了 8 名 2000 年至 2019 年间诊断为 RT 的患者。数据以回顾性和前瞻性的方式收集。所有患者的组织病理学特征均证实了诊断。评估了短期到中期用 GCs 治疗，然后长期用 TMX 治疗的结果。结果：诊断时的平均年龄为 40.5 ± 6.8 岁；观察到女性占优势 (F/M:7/1)。与 IgG4-RD 相关的参数，如 IgG4 血清水平、总浆母细胞计数和 IgG4+ 浆母细胞的增加，在我们大多数处于疾病活动和非活动状态的患者中均为阴性。同样，仅在 2 例中观察到 IgG4/IgG 阳性浆细胞 #x3e;40% 的比例增加。对患者进行 GC 后进行 TMX，总体中位随访时间为 67 (8-216) 个月。所有患者在临床上都有显着改善，GCs 上的肿块大小减小，随后接受 TMX 治疗。在中位时间为 18.5 (7-96) 个月的 TMX 治疗下，没有患者出现复发。结论：尽管 RT 被认为是 IgG4-RD 的成员，但 IgG4 升高或阳性的血清学或组织学证据仅对 RT 的诊断和随访有用。诊断应基于临床和放射学证据，并经组织病理学证实。GCs 对初始治疗有效，而 TMX 是长期维持治疗的成功且安全的治疗选择。
欧洲甲状腺杂志